The necessity and process of genetic testing before larotinib/larlotinib treatment

Larotrectinib is a highly selective TRK inhibitor, mainly targeting patients with solid tumors carrying NTRK gene fusion mutations. Since the drug is not based on the location of tumor occurrence, but is based on molecular targets, genetic testing before medication is a prerequisite for precise medication. NTRK fusion is a rare but possible genetic mutation in many cancers. Only patients with clear mutations may benefit from larotrectinib, and genetic testing is extremely necessary.

In clinical practice, before the use of larotrectinib, it is necessary to determine whether there is NTRK1, NTRK2 or NTRK3 gene fusion through high-throughput sequencing (NGS) or fluorescence in situ hybridization (FISH), reverse transcription PCR (RT-PCR) and other technical means. It is generally recommended to give priority to RNA-based detection methods because they are more sensitive and comprehensive in identifying fusion genes. The process generally involves collecting tumor tissue samples or liquid biopsy samples and sending them to a qualified molecular diagnostic laboratory for testing.

It is worth noting thatNTRK fusion has a low overall incidence in common adult tumors, but it is more common in some rare tumors such as infantile fibrosarcoma, salivary gland secretory carcinoma, papillary thyroid carcinoma, etc. Therefore, NTRK fusion screening has practical clinical significance for cancer patients with difficult diagnosis or poor response to treatment, especially recurrent or metastatic tumors.

Genetic testing before medication can not only determine treatment indications, but also help avoid ineffective treatments, avoid financial and time waste, and assist doctors in formulating personalized treatment strategies. Therefore, in the context of the increasing development of precision medicine, larotrectinib is an important representative of "gene-driven tumor" treatment. Its pre-drug molecular testing process cannot be ignored and has become an indispensable part of modern tumor treatment.

Reference materials:https://www.vitrakvi.com/